Gp Attachment 2

hye guys..sorie for the late entry of the second part of my gp attachment experience...i was kinda busy for the past few days plus my unwell condition made me sleep like a sleeping beauty on a bed of roses..cewahh.huahuah...ok

Name: Mr P
Age: 62
Gender: Male
Presenting Complaint: Chest pain. Based on the story from Mr. P he was doing his job as should i say hard labour or something like that in Limerick that he feel the pain. He was strong enough to persist the pain and still traveled back to cork and he immediately called his GP and he was instructed to go straight away to the Cork University Hospital.if you see the movies or drama 99% people having Chest pain died on the spot but thats definitely a false info..wanna prove??Mr P did make himself travel from Limerick to Cork in that condition and still alive..

History of Presenting Complaint:
Site: Central Chest
Onset: Accute
Character: Stabbing Pain
Radiation: radiates to arm, fingers and to the neck
Associated Symptoms: Sweating,Dizzyness
Timing: Last for 30 minutes
Exacerbating Factors: Heat in the car
Scale: 7/10
(remember Socrates each time patient present with pain so that you don't miss important points)

He also said that he sometmes got breathlessness and he has to stop from doing his work like swingging hammers. He also said that he got intermittent claudication on hip calves and thigh while walking.Besides he also has ankle swelling in hot weather.Apart from that he always feel tired. He has to sleep with 3 pillows and its easier for him to sleep on the chair that the bed

Past medical History
He got his hip replacement surgery due to arthritis. His B.p is Fine, He's taking Aspirin, Beta blocker, Statin

Family History
His Brother also got his hip replaced and his sister has asthma

Social History
He smoke 20 ciggerates per day now and before it was 40 per day for 45 years
(1 pack year = 20 ciggarets per day for a year) so let say he reduced to 20 for the last 5 years therefore it should be 85pack years(OMG)
Drink 12 pints per week
(2 unit= 1 pint)Therefore 24 units perr week.the suggested value for WHO for alcohol is 21 units for male
He work as a hard labour for 11 hours per day
Diet:loves greasy food

So guys, any diagnosis???hurmmm...make ur clinical diagnosis based on the history. this is a classic symptoms of cardiovascular patients...saper dapat diagnosis shedot belanja nasik kandaq..wahahaha